Ask the expert
It is vitally important if you are experiencing any of the digestive symptoms discussed on our 'Symptom Awareness' page that you see your GP as soon as possible for a diagnosis. However, if you have a non-urgent question regarding gut health that you would like answered, please send it in to us - and each month, one of our medical experts will answer a selection of questions.
To ask our experts a question, please click here.
All questions below have been submitted by members of the public. All details remain confidential.
Questions answered by Dr Tony Leeds, visiting Senior Fellow at the University of Surrey
Please note responses should not be considered as a substitute for medical advice; please consult your GP for further consultation.
Q) I am sick regularly in the morning, it is nearly always an acidy sick or plenty of saliva. I don’t drink very often or eat late. I have has this issue on and off for 10 years.
A) Although this is a long-standing problem you should discuss this with your doctor, who will find out if your acidity is linked to some other problem like heartburn, dyspepsia or long-standing sore throat (pharyngitis).
Q) Hello! I’m a 21 year old girl who is healthy and I exercise a lot, but my problem is that I have a lot of wind! Quite embarrassing as i go kickboxing twice a week and never do I go with out flatulence and I always feel bloated! I have no allergies. Please help me!
A) It is possible that you are a ‘good fermenter’ – you pass a fair amount of carbohydrate residues into your colon (lower gut) and your colon bacteria convert them to wind. Try reducing your fibre intake especially from beans, lentils and nuts for a few days to see if this helps. Taking a probiotic may also help.
Q) Hello there. I had irritable bowel diagnosed in my 30s during a period of overwork. I'm now 64 and having quite bad ab pains - bad when I get up in the morning, almost a muscular pain when I sit up, and often goes off but this week has persisted. Took two ibuprofen today, which is unlike me. Have had two colonoscopies, ten years ago and six months ago, both clear. Am on ramipril for hypertension and do tend to suffer from a bit of stress/depression. Believe this may be IBS and hope for some advice. Have presented various maladies to my GP last 2-3 years, so seeking an expert alternative in case she thinks I'm a hypochondriac!
A) Irritable Bowel Syndrome is a diagnosis made after other conditions have been excluded. Since your recent colonoscopy was normal then yes IBS is a likely diagnosis.
Q) I suffer from constipation and it is getting worse my GP prescribed me lactulose and it mostly does the job in the past, but recently I’m either constipated bad occasionally needing to use suppositories. I had a thru the post end of 2007 bowel cancer test via post it came back clear. I am a grade 2 diabetic also have an ulcer, and heart disease (had bypass in 97). I’m aged 70, should I see my GP?
A) Yes, we advise that you consult your GP. It is very important to consider all possible causes of the change in symptom pattern and your GP will do this.
Q) For many years I have had very loose broken up stools. They are pale in colour and I have to go in a hurry several times a day. I also have severe flatulence with an awful smell and my stomach feels like world war three is going on in there. It gurgles so loudly people across the room can hear it. I also feel constantly lethargic. I am 43 and have a pretty good diet. I dare not enjoy a night out without dosing up on Mebeverine first. What is wrong with me please?
A) Pale stools can mean several things, but suggest that you have a very fast transit time. Try reducing your fibre intake especially from beans, lentils and nuts for a few days to see if this helps. Taking a probiotic may also help, but it may be wise to consult your GP who will check other things like your body weight and consider possible causes for this more troublesome flatulence.
Q) I have fairly regular bowel habits during the week, but at weekends I get constipated which can be uncomfortable with bloating. I eat plenty of fruit and have a reasonably healthy diet but I can't understand why this happens.
A) It is common for people to have different diet and lifestyle at the weekends. Why don’t you see if a high fibre cereal taken at breakfast time every day will help. Also ensure that your exercise pattern is regular throughout all seven days. Try the effect of a probiotic every day for several weeks. If these ideas do not help please ask your doctor to help.
Q) My Problem has been diagnosed by a gastroenterologist many years ago. I have had IBS since an attack of Amoebic dysentery in Africa in 1962. I now have very extensive diverticular disease. I live with my problem, but I notice that I am having to take Amoxycillin and Metronidazole more frequently to clear infection in the diverticulae, causing pain and severe bouts of diarrhoea. Sometimes now the drugs do not work and I have to take Ciprofloxacin which always works, up to now. Is my problem going to worsen as I get older? I am 72. My routine drugs are Merbentyl and Colpermin 2 bid of each, and Imodium instant melts when diarrhoea occurs. Thank you.
A) I would recommend a complete review of your problem by a gastroenterologist unless this has already been done in the last year or so. What you are doing now is fine but I think that you are wise to ask how this condition is likely to progress. Ideally you need to be reviewed in a specialist centre.
Q) Constant loose stools for 2 years - all clear from colonoscopy and gastroscopy - staying clear of bread and cereals but still continues - would colonic help and aloe vera - any suggestions please?
A) You have clearly had the obvious investigations and I assume that the full set of investigations for chronic diarrhoea have been done. There has to be a cause for your problem though you don’t say whether you are definitely proven to be intolerant of cereals. It would be wise to ensure that all lines of investigations have been completed – you are entitled to ask about this – before considering remedies for which there may be some evidence but where more is needed.
Q) I have flatulence every day and (for about 2 years). I've tried everything, but nothing works to stop this very embarrassing problem. I am female age 50. I don't have a different diet from I ever had so it’s not to do with change of eating habits. I just eat normally, fruit some veg and meat or chicken. Been to Dr but she is perplexed as my bowels seems normal otherwise. Any idea what can cause this?
A) Try reducing your fibre intake from beans, lentils and nuts for a few days to see if this helps. Taking a probiotic may also help. Sometimes flatulence occurs when bowel movements are slow so regulate your bowels by using a high-fibre breakfast cereal, give plenty of time in the morning to empty your bowels, take enough exercise and get a good amount of sleep (seven hours). Note that you would be increasing cereal fibre but decreasing fibre from beans etc. Alternatively you may be one of a small group who have a bacterial pattern which gives lots of flatulence – ask your GP for a referral to your local gastroenterologist.
Q) My faeces are very loose, bordering on liquid, when I rise in the morning I have to dash to the toilet to avoid 'accidents'. I am on omeprazole at the moment and have been for about 5 years now for a Barretts Oesophagus. I also suffer from bad wind at both ends for which I have spoken to my GP who to be honest doesn't seem that interested. Whilst I believe that I may have some side effect from the drug do you think this condition is acceptable or should I be looking at another cause?
A) I think that you need a thorough ‘work-up’ by a specialist gastroenterologist to determine the cause of your diarrhoea and other symptoms. Ask your GP for a referral – you have a right to ask for this.
Q) I have IBS and have my bowels open for say five days running (normal stools) then not again for another 5/7 days (regular pattern). However I find that I pass clear fluid (no smell or colour) on the days when my bowels are not open. It is not really mucus just clear liquid (I need to rush to the loo). Can you explain what this may be? Many thanks
A) Since you have a diagnosis of IBS I think that your early morning urgency is due to this. The fluid you pass is secretion from the lower bowel and will contain some mucus [which is colourless].
Q) I suspect I have low stomach acid levels, following the bicarb of soda test and also because, although I have a slight hiatus hernia, I have never suffered heartburn. What can I do or take to regulate my digestion (and flatulence). I eat very healthily and do not eat meat.
A) Your use of ‘suspect’ suggests that a proper diagnostic process has not yet been followed. Discuss with your GP whether or not you should go forward for specialist review to sort out the significance of your symptoms.
Q) I have been treated by a nutritionist for Candida in the gut as i was plagued by symptoms of cramps, diahorrea, bloating and occasional constipation (as well as others). After a couple of months off foods (I also had food intolerances) my symptoms have vastly improved. Except now I am constipated. I am drinking lots of water, eating fruit and veg, wholemeal bread, porridge and am exercising but am still constipated. I have been to the toilet but very soon after, feel constipated. My nutritionist is on maternity leave at the minute and I stumbled across this website so thought I would put it to you to see if you had any ideas?
A) Wholemeal bread and oat porridge while being good sources of fibre are not ideal for regulating the bowel. May I suggest that you try one of the very high fibre cereal products, i.e. those that give a super dose of fibre in one portion, regularly for a few weeks. Alternatively you could buy an over-the-counter fibre product – the evidence for psyllium in treating constipation is good. However some people remain constipated despite a high fibre intake – a gut transit study often shows that such individuals often have a very slow gut movement (a long transit time). You would need to be referred to a specialist to get this transit time measurement done.
Q) October 2006 I began to experience constipation and have had it ever since. I have seen the doctor and had a colonoscopy and there are no problems. I have a reasonable diet. I have no history of constipation. I had Salmonella in June 2006 and was treated by antibiotics. I took acidophilus afterwards. I have been recommended to take Lactulose, but I would rather have a more natural experience. Also Oct. 2006 I took on new work responsibilities and explored the possibility of returning to Scotland to live after over 30 years in England. I now go to Glasgow the end of Sept. I would greatly appreciate your comments or suggestions.
A) There is some evidence for a beneficial effect in constipation on probiotics so there may be merit in trying a probiotic. At the same time you can obtain ‘natural’ laxation by eating a high fibre cereal product at breakfast [not wholemeal bread or porridge but rather one of the manufacturered high fibre cereals] or taking psyllium which is an over-the-counter natural fibre for which there is a strong scientific literature demonstrating benefit in constipation.
Q) Over the last 1 - 2 years I have experienced bowel problems, they are very sensitive. I tend to get constipated, so eat a high fibre diet, which if i don't everything stops working. I also drink Yakult and have linseed daily, which seems to help. I sometimes get diarrhoea. I had diarrhoea last week which I took imodium for and since my bowels have been sluggish, I am also on nights which doesn't help. Today I had fresh blood in my stools. It doesn't hurt to pass stools, should I go to the doctors or is it just from the diarrhoea and now being constipated. If I do go to the GP, what will they do?
A) You should visit your GP who will approach your problem with sympathy. You need a thorough review of your history and an examination including a check of your back passage (anal canal). It is always important to know why bleeding has occurred.